Pro-Quackery Legislation

Stephen Barrett, M.D.

Instead of conducting scientific studies, quackery's promoters
use anecdotes and testimonials to promote their practices and
political maneuvering to keep regulatory agencies at bay. The
legislative strategies include: (1) protection through licensing
laws, (2) "insurance equality" laws, and (3) weakening
of regulatory agencies.

Licensing Laws

One way for unscientific practitioners to preserve their freedom
to practice is to set up their own licensing boards that permit
them. Chiropractors have been licensed in all 50 states since
1974. Although chiropractic boards occasionally discipline practitioners,
they almost never interfere with quack practices. Naturopaths,
nonphysician acupuncturists, and massage therapists (many of whom
are engaged in bizarre practices) have achieved licensure in fewer
states but are actively campaigning in many others. The achievement
of licensure enables practitioners to assert, "Now we are
recognized by law, insurance companies should have to cover our
services." In many states, vigorous efforts are also being
made to obtain laws that would make it difficult or impossible
for licensing boards to discipline physicians who engage in "alternative"
practices. A few states have passed such laws already. Perhaps
the most dangerous effort related to licensing is the drive in
Minnesota to set up a new "occupation" for "complementary
and alternative health care practitioners who are currently unlicensed."
This would include homeopaths, naturopaths, herbalists, massage
therapists, nutrition and body-mind therapists, and other natural
healers." The proposed law would set no minimum criteria
for either education or clinical competence.

"Insurance Equality" Laws

Most insurance companies do not want to pay for treatments
that the scientific community regards as ineffective. To get around
this, "alternative" providers seek passage of laws to
force insurance policies to cover whatever they do. Bills of this
type are promoted as pro-consumer by stating that they will prevent
"discrimination" and enable consumers to have "freedom of choice."
Chiropractors have used this approach to gain passage of such
laws in more than 40 states. Only a few states force coverage
of other practitioners, but "alternative" proponents
are actively lobbying to change this. Such laws restrict freedom
rather than promote it. The restrict the freedom of insurance
companies to restrict their coverage to proven treatments, and
they force many policyholders to pay for quack practices whether
they want to do so or not.

Weakening of Regulatory Agencies

Quackery's proponents have succeeded in curbing the FDA's ability
to regulate "dietary supplements" and herbs and would
like to cripple the ability of state licensing boards to discipline
unscientific practitioners.

The Proxmire Amendment (1976) to the federal Food, Drug, and
Cosmetic Act prohibited the FDA from limiting the potency of ingredients
of vitamin and mineral products that are not inherently dangerous.
This bill prevents the FDA from ridding the marketplace of useless
"dietary supplement" ingredients and irrational combinations
of ingredients. The bill was passed because the health-food industry
misled many of its customers into believing that the FDA intended
to greatly restrict the sale of supplement products. More than
a million protest messages poured into Congress as a result.

The Dietary Supplement
Health and Education Act (DSHEA) was passed in 1994 following
another massive lobbying campaign by the health-food industry.
This law defined "dietary supplements" to include herbs
as well as any substances purported to "supplement the diet
by increasing dietary intake" and prevents the FDA from removing
worthless ingredients from the marketplace. It also permits sellers
to use misleading third-party literature to promote the sale of
their products. This law has greatly weakened the ability of the
FDA to protect consumers against unsubstantiated claims. Since
its passage, even hormones such as DHEA and melatonin are being
hawked as supplements.

The Access to Medical Treatment Act,
introduced by Rep. Peter DeFazio (D-OR), is claimed to permit
health-care practitioners to provide "any medical treatment
that the individual desires" that does not violate licensing
laws. Practitioners may provide the treatment if: (a) it is not
known to be directly harmful, (b) the patient is given written
notice that the treatment is not government approved, and (c)
written information is provided about the nature, anticipated
benefits, and foreseeable side effects of the treatment. The Act
would also require that dangerous outcomes be reported to the
Secretary of Health and Human Services and that beneficial outcomes
be reported to the NIH Office of Alternative Medicine. Although
couched as an effort to preserve patient freedom, the bill's real
purpose is to prevent government interference with unscientific
practitioners. The alleged safeguards fail to protect patients
from practitioners who misrepresent worthless methods as beneficial
(as most "alternative" practitioners do). Many of its
proponents spearheaded DSHEA's passage.

The Consumer
Health Free Speech Act, introduced by Rep. Ron Paul (R-TX),
would amend the Federal Food, Drug, and Cosmetic Act by inserting
the words "(other than food, including dietary supplements)"
into its definition of the term "drug." The amended
definition would read "articles (other than food, including
dietary supplements) intended for use in the diagnosis, cure,
mitigation, treatment, or prevention of disease in man."
The bill's intention is to make it impossible for the FDA to regulate
claims made for any product that a seller labels as a dietary
supplement.

Bogus Food Safety Legislation

The Genetically
Engineered Food Right to Know Act (H.R. 3377), introduced
by Rep. Dennis Kucinich (D-OH), would require labels on food that
contains or is produced with genetically engineered material,
which it defines as material derived from any part of a genetically
engineered organism, without regard to whether the altered molecular
or cellular characteristics of the organism are detectable in
the material. The Institute
of Food Technologists have concluded that genetic modification
is safe, will increase world food production, and can improve
plant characteristics that will benefit farmers, consumers, and
the environment. The FDA
has stated that special labeling would be inappropriate unless
a technique significantly changes the composition of a food. Proponents
of labeling claim that legislation is needed to enable consumers
to exercise their "right to choose." Many critics of
biotechnology see labeling as an indirect way to undermine public
trust in biotechnology.

For Additional Information

Three web sites provide political information from the viewpoint
of "alternative" proponents.

Citizens for Health
is a grass-roots organization dedicated to what it calls "freedom
of choice." Its primary activity is generating letter-writing
campaigns. Its primary target has been FDA regulation. Its Web
site discusses more than a dozen issue.

Natural
Health Village emphasizes federal legislation and provides
links to the email addresses of Congressional representatives.
It also offers a free email newsletter. The site operator is
Michael Evers, Esq., adopted son of the late H. Ray Evers, M.D.,
considered "the father of chelation therapy." Michael
Evers also offers a free email newsletter.

Monica
Miller Government Relations focuses on "advocacy before
state legislatures and administrative agencies regarding issues
of alternative medicine in relation to state licensing laws,
professional conduct, health insurance and managed care, and
clinical laboratories." Ms. Miller is an active lobbyist
and consultant who describes herself as "an alternative
medicine advocate and patient's rights advocate and policy researcher."

Hearing
on Patient Access to Alternative Treatments: Beyond the FDA
presents the text of prepared testimony on the "Access to
Medical Treatment Act" presented on February 4 and 12, 1998,
to the U.S. House of Representatives Committee on Government
Reform and Oversight (Dan Burton, chairman). All but one of the
presenters favored passage of the bill.